ADHD and Brain Anatomy: What Do Academic Textbooks Used in the Netherlands Tell Students?

Studies of brain size of children classified with ADHD appear to reveal smaller brains when compared to ‘normal’ children. Yet, what does this mean? Even with the use of rigorously screened case and control groups, these studies show only small, average group differences between children with and without an ADHD classification. However, academic textbooks used in the Netherlands often portray individual children with an ADHD classification as having a different, malfunctioning brain that necessitates medical intervention. This conceptualisation of ADHD might serve professional interests, but not necessarily the interests of children

ADHD and reification: Four ways a psychiatric construct is portrayed as a disease

IntroductionThe descriptive classification Attention-Deficit/Hyperactivity Disorder (ADHD) is often mistaken for a disease entity that explains the causes of inattentive and hyperactive behaviors, rather than merely describing the existence of such behaviors. The present study examines discourse on ADHD to analyze how authors passively and actively contribute to reification—a fallacy in which a concept is represented as a thing existing on its own.MethodsCritical Discourse Analysis and Qualitative Content Analysis of academic textbooks, scientific articles, websites and videos were used to analyze how ADHD is reified.ResultsThe analyses reveal four ways in which inattentive and restless behaviors are presented as an entity by means of the ADHD classification: language choice, logical fallacies, genetic reductionism, and textual silence. First, language choice, such as medical jargon and metaphors aid in representing ADHD as a disease entity. Second, several logical fallacies do the same, including the relatively unknown “ecological fallacy” that refers to the erroneous belief that average group findings, such as average brain size of groups of those with an ADHD classification, can be applied on an individual level. Third, genetic reductionism is often achieved by overstating the results of twin studies and being silent about the disappointing molecular genetic research. Such textual silence is the last identified mechanism of reification and includes instances in which societal factors that affect the ADHD construct are often omitted from texts, thereby obscuring the extent to which ADHD is a limited heuristic.DiscussionIt is essential that discourse communities do not repeat these four ways of reifying behavior and social relations into an alleged entity with the acronym ADHD. The errors and habits of writing may be epistemologically violent by influencing how laypeople and professionals see children and ultimately how children may come to see themselves in a negative way. Beyond that, if the institutional world shaped to help children is based on misguided assumptions, it may cause them harm and help perpetuate the misguided narrative. To counter the dominant, reifying and medicalizing view, guidelines such as the recently published “Dutch ADHD Psychoeducation Guidelines” might be helpful

Study books on ADHD genetics:balanced or biased?

Academic study books are essential assets for disseminating knowledge about ADHD to future healthcare professionals. This study examined if they are balanced with regard to genetics. We selected and analyzed study books (N=43) used in (pre) master's programmes at 10 universities in the Netherlands. Because the mere behaviourally informed quantitative genetics give a much higher effect size of the genetic involvement in ADHD, it is important that study books contrast these findings with molecular genetics' outcomes. The latter studies use real genetic data, and their low effect sizes expose the potential weaknesses of quantitative genetics, like underestimating the involvement of the environment. Only a quarter of books mention both effect sizes and contrast these findings, while another quarter does not discuss any effect size. Most importantly, however, roughly half of the books in our sample mention only the effect sizes from quantitative genetic studies without addressing the low explained variance of molecular genetic studies. This may confuse readers by suggesting that the weakly associated genes support the quite spectacular, but potentially flawed estimates of twin, family and adoption studies, while they actually contradict them

What children and young people learn about ADHD from youth information books: A text analysis of nine books on ADHD available in Dutch

Attention Deficit Hyperactivity Disorder (ADHD) is not a singular concept. For the purposes of this study, understandings of ADHD are assumed also to spread along a conceptual dimension that includes some combination of biomedical and psychosocial knowledge. Biomedically, ADHD may be considered a somatic affliction causing inattention and hyperactivity, amenable to pharmaceutical treatment. Psychosocially, ADHD ranks among adverse behaviour patterns that are amenable to psychosocial and pedagogical intervention. Considering both biomedical and psychosocial factors are associated with the ADHD construct, it seems self-evident that young people should be offered information that gives equal consideration to both ways of addressing ADHD, but the question is just how balanced the information available to young people is. This study investigated nine information books on ADHD available in the Netherlands in Dutch, aimed at children and young people up to age 17. Thirteen perspective-dependent text elements were identified in qualitative content analysis. Eight attributes associate with a biomedical view: ADHD as cause, biological factors, clinical diagnosis, brain abnormality, medication, neurofeedback, heritability and persistence. Five text elements associate with a psychosocial view: ADHD as perceived behaviour, environmental factors, descriptive diagnosis, behavioural intervention and normalisation. The most frequent text passages encountered describe ADHD as a brain abnormality, along with medical and behavioural treatment. Providing the main focus for information in eight out of nine books, biomedical information about ADHD predominates in the available youth information books, while psychosocial information about ADHD is far less well covered

Why ADHD is not a brain disorder and how we keep suggesting it is: the problem of reification

PARALLEL SESSIONS VIII<br/>Symposium 36 | SY-036 (10720)<br/>Psychiatrization of society – a call for debate<br/

Why ADHD is not a brain disorder and how we keep suggesting it is: the problem of reification

PARALLEL SESSIONS VIII<br/>Symposium 36 | SY-036 (10720)<br/>Psychiatrization of society – a call for debate<br/

Why ADHD is not a brain disorder and how we keep suggesting it is: the problem of reification

Invited as a speaker by Timo Beeker to replace a speaker who had to cancel